Harassment or Bias Incident Report

IF YOU ARE DEALING WITH AN EMERGENCY SITUATION, PLEASE CALL 911 AND COMPLETE THIS FORM LATER.

This form should be used to report any event believed to have been hate- or bias-motivated and that happened to you at Macalester College or in the Twin Cities area. Your responses can be anonymous unless you chose to include identifying information on this form.

If you would like to report an incident in person, please contact the Title IX Coordinator at 651-696-6258, the Office of Student Affairs at 651-696-6220, or Campus Security at 651-696-6555.

Nature of Incident (check all that apply)
Graffiti
Posters
Threat of harm
Derogatory jokes or comments based on a social identity (race, religion, sex, ability, religion, etc.)
Notes, letters, or written message
E-mail
Physical force or Incident
Other (please explain)

Please provide a detailed description of the incident (including relevant information about what happened immediately before and after the incident).

Which aspects of identity were being targeted: (check all that may apply)
Race
National Origin
Ethnicity
Immigration status
Gender Identity
Sexual orientation
Social/Economic Class
Religion
Ability
Other (please specify)

Please describe the person(s) you believe to be responsible for this incident.

The person completing this form is:
A victim of the incident
A witness to this incident
A friend or acquaintance of the victim who did not witness the incident
A friend or acquaintance of the perpetrator(s) who did not witness the incident

Was this incident reported to anyone, and if yes, who?

If you would like a trained ally or staff member to contact you to follow up on this report, please enter your contact information below:

Name:

E-mail:

Phone number:

User Comment:Please do not put anything in this field

Thank you for completing this report. Your information helps us to track and respond to hate and bias on campus. Please take a minute to read over and confirm your answers before you submit them.